Individual
HALEY PETERSON HOSTETLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4300
(503) 494-4323
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4300
(503) 494-4323
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD211432
OR
207R00000X
Internal Medicine Physician
MD211432
OR
208000000X
Pediatrics Physician
MD211432
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982022265
—
NC
Enumeration date
04/03/2014
Last updated
01/20/2023
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